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Query: UMLS:C0153429 (Meckel's diverticulum)
 1,196 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of Meckel's diverticulum causing intussusception in an 8-year-old boy is presented. The Meckel's diverticulum was detected by using a Tc-99m-labeled antigranulocyte monoclonal antibody MN3 (Leukoscan; Immunomedics, Morris Plains, NJ), which is under clinical evaluation for the detection of atypical appendicitis at the authors' institution. Pathologic evaluation confirmed Meckel's diverticulitis with ileal-ileal intussusception.
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PMID:Intussusception secondary to Meckel's diverticulum detection with Tc-99m monoclonal antibodies to granulocytes (Leukoscan). 892 42

Meckel's diverticulum is the most common congenital abnormality of the gastrointestinal tract. Complications most frequently arise in children younger than 2 years who present with gastrointestinal bleeding. The diagnosis is usually made via radionuclide scintigraphy or intraoperatively. The authors report a 71-year-old man who developed a sudden onset of right lower quadrant abdominal pain, without bleeding, and was diagnosed as having Meckel's diverticulitis via computed tomography. The presence of Meckel' s diverticulitis was confirmed at surgery. Complications of a Meckel's diverticulum must be considered at any age. Computed tomography is another modality that may be helpful in the preoperative diagnosis.
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PMID:Meckel's diverticulitis in an elderly man diagnosed by computed tomography. 1063 19

Complications of the Meckel's diverticula are well-known and defined. However, acute inflammation and perforation secondary to a calculus is a rare clinical presentation. A case of acute calculous Meckel's diverticulitis with perforation in a 58-year old man is presented and possible pathological conditions are discussed. Location of the perforation, apical microscopic focal ulcers, and ischaemic changes in the diverticulum remind the pathogenesis comparable to that of acute calculous cholecystitis. This case report with major complications related to Meckel's diverticulum strengthens the concept of prophylactic resection of Meckel's diverticulum in adults, incidentally discovered at laparotomy.
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PMID:Perforation of acute calculous Meckel's diverticulitis: a rare cause of acute abdomen in elderly. 1114 26

Meckel's diverticulitis is a rare disease. In addition to physical examination, abdominal ultrasound can help to pinpoint the diagnosis. By presenting a case report we would like to demonstrate the typical ultrasonographic findings in acute Meckel's diverticulitis and differentiate it from acute appendicitis. A 60-year-old patient was admitted to our hospital with the diagnosis of acute appendicitis. Abdominal ultrasound was performed and a blind ending, liquid-filled segment of small bowel in the right lower quadrant of the abdomen found. This segment was not compressible, no peristalsis was evident, nor was there any anatomical association with the cecum. Locally we found free fluid and hints of inflamed mesenteric fatty tissue. A perforated Meckel's diverticulum was diagnosed and confirmed intraoperatively. The major ultrasonographic difference between an inflamed Meckel's diverticulum and acute appendicitis is its anatomical location. In contrast to the appendix there is no association with the cecum. A diameter of up to 40 mm and a well-defined wall of small bowel with 3 definite layers visible by ultrasound may help to distinguish between a Meckel's diverticulum and the appendix.
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PMID:[Ultrasound diagnosis of Meckel diverticulitis in adults]. 1121 72

The Authors describe a case of gastrointestinal bleeding from a Meckel's diverticulum due to acid production by the heterotopic gastric mucosa and a case of bowel obstruction for the presence of a Meckel's diverticulitis. Diagnostic difficulties and choices of surgical therapy are then discussed.
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PMID:[Complications of Meckel's diverticulum]. 1159 65

A thirteen-year old girl presented with acute right lower quadrant abdominal pain for which evaluation suggested appendicitis. At laparotomy, the appendix was normal but a Meckel's diverticulum with an impacted Taenia saginata (tapeworm) was found. The diverticulum was excised and histopathology confirmed diverticulitis from the parasite. Though Meckel's diverticulitis due to parasites has been reported, this is usually from ascaris. Tapeworm causing this complication is rare.
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PMID:Meckel's diverticulitis due to Taenia saginata: case report. 1168 41

This case reports the concomitant findings of carcinoid tumor within a Meckel's diverticulum presenting as an acute abdomen in an adult male. Most Meckel's diverticula remain asymptomatic throughout life, and symptomatic diverticula are virtually nonexistent in older adults. Meckel's diverticulitis is clinically indistinguishable from acute appendicitis, and abnormal or symptomatic diverticula are generally resected. Surgical treatment of Meckel's diverticula is recommended for children during exploration. However, resection is controversial in asymptomatic adults. Carcinoid tumors are the most common primary tumor of the small bowel. The duration of symptoms before diagnosis varies from 2 to 20 years, and half of all patients have incurable abdominal disease at first-look surgery. Metastatic events occur most commonly in the liver with a generally poor prognosis. Surgical resection is the treatment of choice. Both Meckel's diverticula and carcinoid tumor are rare clinical entities, and carcinoid tumors occurring within a Meckel's diverticulum are even more uncommon. Thus, the natural history is difficult to predict and treatment recommendations vary. Solitary, localized, asymptomatic nodules less than 1 cm are generally managed with diverticulectomy or segmental resection. Larger or multiple lesions require wide excision of bowel and mesentery, and hepatic resection may be required for metastatic disease.
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PMID:Meckel's diverticulitis secondary to carcinoid tumor: an unusual presentation of the acute abdomen in an adult. 1497 61

Meckel's diverticulum, which is a remnant of the omphalomesenteric or vitelline duct, is the most common congenital abnormality of the gastrointestinal system. Urachal abnormalities, resulting from anomalous urogenital development, are not observed frequently and case reports are mainly represented in literature. The presence of these two congenital anomalies together is a very rare pathology. Complications arising from a Meckel's diverticulum or urachal remnant may clinically mimic acute appendicitis and other surgical pathologies. We report on a patient who underwent surgery for acute appendicitis when it was discovered that the symptoms were produced by a perforated Meckel's diverticulitis. In the course of the surgery, a urachal remnant was found to coexist with the diverticulum.
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PMID:Coexistence of a Meckel's diverticulum and a urachal remnant. 1618 22

Meckel's diverticulum (MD), a seemingly innocuous anomaly of the gastrointestinal tract, presents distinctive challenges to a clinician, as it is prone to varied complications that are frequently elusive to diagnosis with conventional diagnostic modalities. This case series illustrates the diverse presentations and advantages of laparoscopic-assisted management of Meckel's diverticular complications in children. Between October 2002 and April 2006, 36 patients (27 males and 9 females) aged 1.5 to 16 years (median 10 years) underwent laparoscopic-assisted trans-umbilical Meckel's diverticulectomy (LATUM). Sixteen (44.4%) patients presented with lower gastrointestinal bleeding (14 with painless bleed and 2 with perforated peptic ulcer in the ileum adjacent to the MD), six (16.7%) patients presented with intestinal obstruction (four due to a mesodiverticular band and one each due to intussusception and floppy giant cystic dilatation of MD causing intestinal compression) and four (11.1%) patients presented with features masquerading as appendicitis (one with Meckel's diverticulitis and perforation, one with perforated peptic ulcer adjacent to MD and two with a torted and gangrenous MD). In ten (27.8%) patients, incidental MD with a narrow base was noted at laparoscopic exploration for suspected appendicitis. All patients underwent successful LATUM along with appendicectomy in 15 (41.7%) patients. The operative duration ranged from 72 to 266 min (mean 125.9+/-48.4). There were no intra-operative complications and none required conversion to open surgery. The hospital stay was 3 to 9 days (mean 5.3+/-1.2). There were three (8.3%) cases of postoperative adhesive intestinal obstruction; two underwent successful laparoscopic adhesiolysis and one necessitated conversion to suprapubic laparotomy to release the pelvic adhesions. There were no other complications during the follow-up (median 16 months). LATUM is a safe, effective and an esthetic procedure offering timely diagnosis and cure for diverse Meckel's diverticular complications. The technique also allows palpation of the MD and avoids usage of expensive staplers.
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PMID:Meckel's diverticular complications in children: is laparoscopy the order of the day? 1717 78

Meckel's diverticulum (MD) has varied presentations and often becomes a diagnostic challenge. The purpose of this study was to review the various presentations of symptomatic MD and to assess the sensitivity of the Meckel's scan as a diagnostic tool in patients with bleeding MD. The hospital records of 71 consecutive patients with a diagnosis of MD from 1990 to 2005 were retrospectively reviewed. The data was assessed for age at presentation, sex, clinical features, investigations performed, surgical intervention and histopathological findings. There were 71 patients with a diagnosis of MD (age 2 days-14 years). In eight patients, MD was an incidental finding at laparotomy. The remaining 63 patients were symptomatic and presented with various clinical features. Ten patients (15.8%) had clinical features of peritonitis; of these, six had perforated MD and four had Meckel's diverticulitis at laparotomy. Nine patients (14.2%) were diagnosed as intestinal obstruction, and at laparotomy, a Meckel's band was found to be the cause of the obstruction. Nine patients (14.2%) had a patent vitello-intestinal duct and presented with umbilical discharge. Thirty-five patients (55.5%) presented with episodes of bleeding per rectum or malaena. Ultrasound scans revealed intussusception in six patients requiring open reduction. Of the remaining 29 patients with bleeding per rectum, 27 underwent a Meckel's Tc99 scan that showed a positive tracer in 18 patients (66.6%) and negative in 9 (33.3%). All patients with a symptomatic MD underwent resection of the diverticulum. Histology revealed ectopic gastric mucosa in 43 patients (68.3%). MD has various presentations and can be easily misdiagnosed. It is necessary to maintain a high index of suspicion in the paediatric age group. The Meckel's scan has a poor positive predictive value and cannot be relied upon for a diagnosis in cases of bleeding MD if Tc99 scan is negative.
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PMID:Symptomatic Meckel's diverticulum in children: a 16-year review. 1832 89


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